Factors associated with participation in employment for high school leavers with autism

Authors: 
Chiu, C., Chan, F., Strauser, D., Feuerstein, M., Ditchman, N.,Cardoso, E., O'Neill, J., & Muller, V.
Year Published: 
2013
Publication: 
Journal of Autism and Developmental Disorders
Volume: 
43
Number: 
8
Pages: 
1832-1842
Publisher: 
Springer US
Background: 

Research about what happens after students with autism leave high school is limited. Some research has focused on factors related to transitioning from school to work. In addition a few studies have investigated predictors of participation in employment for individuals with autism. Individuals with autism would like to be gainfully employed but many barriers exist. To help ensure a successful transition from secondary school to work more information about the factors associated with this process is needed.

Purpose: 

This study used a national representative data set to identify factors associated with employment.

Setting: 

The setting for this study is not described.

Sample: 

A secondary data analysis of NLTS2 longitudinal data set was performed. The sample included 830 secondary school students (ages 13 through 16) who had autism as a primary disability. The study sample was taken from currently available NLTS2 raw data from Institute of Educational Sciences.

Data Collection: 

This included data from the NLTS2 Waves 1 to Wave 4 parent/youth phone interview and/or mail survey data (Wave 1 was collected in the 2000–2001; Wave 2 was collected in the 2002–2003; Wave 3 was collected in the 2004–2005; and Wave 4 was collected in the 2006–2007 school years) and Wave 1 to Wave 2 school program survey data (Wave 1 was collected in the 2001–2002 and Wave 2 was collected in the 2003–2004 school years). The information was gathered for the first time in the 2000–2001 school year and last time in the 2006–2007 school year. SAS 9.2 was used for statistical analyses. All the data used had no missing values. The cases containing missing values were removed. Variables were described using descriptive statistics. Continuous variables, values were reported as means ± standard deviations (SDs). Categorical variables, values were reported as percents. A three-step process was used to determine the factors significantly associated with participation in employment for students with autism.

Intervention: 

There were several interventions. These included school based counseling and vocational services as well as contacting post secondary service providers.

Control: 

There was no control or comparison condition.

Findings: 

Among those students who left high school (weighted n = 4,167), 56 % (weighted n = 2,333)had participated in employment after exiting high school and 44 % (weighted n = 1,834) had not. The average age of those who went to work was 21 years. They worked in 29 different types of occupations. The top five job types included: material recording, scheduling, dispatching, and distribution (36.3 %), information and record clerks (12.9 %), building cleaning and pest control workers (8.5 %), retail sales workers (5.2 %), and other production occupations (5.1 %). The mean hourly wage was $7.90 with a range from $2.00 to $30.00, (SD = $22.00).

Conclusions: 

Family social status, student characteristics, and high school transition planning services were the significant factors that impacted whether or not individuals participated in employment.

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/23224594
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
No

The community initiative on depression: Report from a multiphase work site depression intervention

Authors: 
Chiang, H., Cheung, Y. K., Huacheng Li, H., & Tsai, L. Y.
Year Published: 
2005
Publication: 
Journal of Occupational and Environmental Medicine
Volume: 
47
Number: 
1
Pages: 
60-67
Publisher: 
2005 The American College of Occupational and Environmental Medicine/ Lippincott, Williams, & Wilkins
Background: 

Depression is a prevalent illness with risk for many deleterious outcomes if under-recognized or under-treated. Depression is a leading cause of work-related disability worldwide. Most people with depression are employed (an estimated 68%). Recognizing and initiating depression care in the workplace will facilitate depression treatment in clinical settings.

Purpose: 

To further understand depression, a common, disabling condition with considerable ramifications for the workplace, including higher costs, absenteeism, and reduced work performance.

Setting: 

A multidisciplinary health care coalition recently implemented a multiphase workplace depression initiative in Kansas City. Results are reported from its first phase, a 22-item, self-administered survey of depression knowledge and attitudes among employees of 13 large, local work sites.

Sample: 

All eligible employees from 13 of the 15 Community Initiative on Depression (CID)-partnered area companies were sampled for survey administration (38,945 subjects). Subjects were mailed instructions for web-based access to the survey, along with paper copies of the survey for those companies offering that option. Subjects were informed that the overall objective of the survey was to further an understanding of workplace depression. Six of the participating work sites were health care industries, two were governmental, three were banking and legal, and two were manufacturing industries. Subject eligibility criteria were older than 18 years of age and had current employment status at 1 of the 13 companies.

Data Collection: 

Researchers performed descriptive univariate analyses for all variables. Researchers were concerned that depression knowledge and attitudes might vary among the work sites, especially among the healthcare industries compared with the non-health care industries. Therefore, researchers examined response differences among company sites. Nevertheless, companies generally were similar in structure, urban location, employee socio-demographics (per general employer-published reports), health care availability, and health care insurance programs. Additionally, most companies were lacking in prior depression awareness-raising programs.

Researchers were also concerned that respondents with a history of depression might have different knowledge, attitudes, and help-seeking behavior than those without a history of depression. Therefore, we examined response differences between those with and without a self-reported depression history.

Intervention: 

Using an iterative, consensus-arriving process with a team of clinical experts and public health practitioners, researchers designed a 22-item, self-administered survey. The survey contained 11 questions regarding depression knowledge in a multiple choice, best-answer format, 7 questions regarding workplace-specific depression attitudes in a 4-point Likert format ranging from agree strongly to disagree strongly, and 4 questions concerning past and current experience with depression in a yes/no format.

Control: 

There was no control or comparison condition.

Findings: 

There were 6,399/38,945 respondents (16% response rate). Most respondents (>90%) appropriately recognized the signs and symptoms of depression. A minority (29%) would feel comfortable discussing depression with their supervisor. Sixty-two percent knew how to access company resources for depression care.

Conclusions: 

Employees were knowledgeable about depression but were less aware of employee-assistance programs for depression care. These findings support increased attempts to raise the awareness of depression and promote of help-seeking behavior in the workplace.

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/15643160
Disabilities: 
Populations: 
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Potential of mobile social networks as assistive technology: a case study in supported employment for people with severe mental illness

Authors: 
Zanis, D. A., Coviello, D., Alterman, A. I., & Appling, S. E.
Year Published: 
2008
Publication: 
10th international ACM SIGACCESS conference on Computers and accessibility
Pages: 
239-240
Publisher: 
ACM Digital Library
Background: 

Mobile social network services are being used to help individuals with mental illness travel to and from work and other places in the community. This prototype system may reduce the amount of time a job coach spends teaching a person a route to and from work and help reduce worries related to safe travel.

Purpose: 

This paper offers a case report about using the prototype.

Setting: 

The setting for this study is not described.

Sample: 

The case study describes a woman with an intellectual disability and epilepsy.

Data Collection: 

Field observations revealed none of the participants got lost. A number of scenarios were set up to test the advance functions of the system. An evaluation also took place. The information gained was used to convince job coaches to participate in upcoming trials and give feedback about how to improve the design.

Intervention: 

The intervention is mobile social networks.

Control: 

There was no control or comparison conditions.

Findings: 

The system takes both location and time into account. This makes it more useful to the end-user and caregivers.

Conclusions: 

Some individuals forget how to travel to work. Mobile social networks can help.

URL: 
http://dl.acm.org/citation.cfm?id=1414517
Disabilities: 
Populations: 
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
No

Tablet-based video modeling and prompting in the workplace for individuals with autism

Authors: 
Burke-Miller, J., Razzano, L. A., Grey, D. D., Blyler, C. R., & Cook, J. A.
Year Published: 
2013
Publication: 
Journal of Vocational Rehabilitation
Volume: 
38
Number: 
1
Pages: 
1-14
Publisher: 
IOS Press
Background: 

The number of adults with autism closed by Vocational Rehabilitation remains low. Employment rates for this group is the lowest for individuals with intellectual disabilities. For instance, the National Longitudinal Transition Study-2 reported that at two years post high school, only 28% of individuals with autism were employed (including competitive, supported, or sheltered employment).

Purpose: 

This article presents the findings from a preliminary study testing computer software across a range of employment settings for young adults with autism.

Setting: 

The study took place in a manufacturing and shipping warehouse in a Midwestern city.

Sample: 

The study sample included four young men ages 19 to 28, with autism spectrum disorder. One young man was Asian American and the other three were European American. All were unemployed; three lived with their parents; one lived in a community-based group home.

Data Collection: 

Participants were asked to complete a shipping task that involved an average of 73 steps. The percentage of task steps completed correctly was calculated by dividing the number of relevant completed steps by the sum of relevant completed and relevant not completed steps and multiplying by 100.

Intervention: 

A task analysis of the job was completed within the shipping department of the large manufacturing and shipping warehouse. The actual task was rental box shipping, which was reported as the most challenging of the shipping tasks due to the number of complex steps. A 13 minute, 10 second video was produced that depicted job responsibilities for the shipping tasks. This video had recorded voice overs to guide the user. The shipping task was then edited into 36 segments so that users could view portions of the task at a time. This video was loaded onto a software program called, VideoTote that was designed for an Android platform and made available to the study subjects on a Samsung Galaxy Tablet. The software was designed with universal design features.

Control: 

This study was a single subject design, the subjects were their own controls.

Findings: 

Results from this study suggest that the combination of video modeling during pre-employment training and on-the-job video prompting was helpful for individuals with autism when completing a complex shipping task.

Conclusions: 

The current study provides preliminary evidence that use of the tablet-based VideoTote software was an effective video modeling and prompting intervention for individuals with ASD in competitive employment. The results suggest that for some individuals with autism, job coaches likely will remain necessary.

URL: 
http://www.scholars.northwestern.edu/pubDetail.asp?t=pm&id=84873177849&
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

An evaluation of the efficacy of training people with learning disabilities in a virtual environment

Authors: 
Brouwers, E. P. M., Tiemens, B. G., Terluin, B., & Verhaak, P. F. M.
Year Published: 
2002
Publication: 
Disability and Rehabilitation
Volume: 
24
Number: 
11
Pages: 
622-626
Publisher: 
Informa Healthcare
Background: 

The majority of people with learning disabilities in the United Kingdom do not get the opportunity to work because they are often denied appropriate vocational training.

Purpose: 

To evaluate the efficacy of using a virtual kitchen for vocational training of people with learning disabilities.

Setting: 

The settings were schools for training in catering for individuals with disabilities in the United Kingdom.

Sample: 

The sample size included 24 catering students with learning disabilities.

Data Collection: 

Pre-test, post-test, and improvement scores were collected.

Intervention: 

The intervention was vocational training in food preparation in the virtual kitchen, real training and using traditional workbook methods.

Control: 

Students were their own controls.

Findings: 

Virtual training was found to be as beneficial as really training and more beneficial than workbook training.

Conclusions: 

Vocational students with learning disabilities were able to use the virtual environment and were motivated to learn using this training method. Depending on the task being trained, virtual training had a more beneficial effect on real task performance than workbook training, even when the virtual kitchen was not modeled on the real training kitchen. (p. 622)

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/12182802
Populations: 
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

The quality of supported employment implementation scale (2000)

Authors: 
Bond, G. R., Salyers, M. P., Dincin, J., Drake, R. E., Becker, D. R., Fraser, V. V., & Haines, M.
Year Published: 
2000
Publication: 
Journal of Vocational Rehabilitation
Volume: 
14
Number: 
1
Pages: 
201-212
Publisher: 
IOS Press
Background: 

Supported employment as an approach to assist individuals with the most severe disabilities, with gaining and maintaining work, has been described in the literature since the nineteen eighties. However, its implementation has been variable in the United States. A scale to measure the quality of supported employment implementation would be beneficial.

Purpose: 

The purpose of this study was to develop a checklist that could be used by program administrators or state planners to measure the implementation of supported employment programs for individuals with severe mental illness.

Setting: 

The study sites were 17 supported employment programs located in Kansas and New Jersey.

Sample: 

A total of 32 supported employment programs participated in the study. Twenty sites were in New Jersey and 12 in Kansas. Between the two states' programs, there was no significant difference in the longevity of the programs, number of employment specialist, number of consumers, staff to consumer ratios. They also did not differ in number of annual admissions.

Data Collection: 

One and half hour semi structured telephone interviews were conducted with program managers using the Quality of Supported Employment Implementation Scale. The subscales were: vocational staffing, organization and services, from the Individual Placement and Support Fidelity Scale. After the interview, procedures were explained about collecting employment outcome data. Program directors were paid $100 for completing this activity. The data related to employment status of current consumers.

Intervention: 

The intervention was the use of the Quality of Supported Employment Implementation Scale to evaluate services.

Control: 

There was no comparison or control condition.

Findings: 

The inter-interviewer agreement was moderately high. Overall, internal consistency of the total scale was poor, so the researchers subscales. All 33 items on the Quality of Supported Employment Implementation Scale showed some variation. Both states showed high ratings suggesting moderate to full implementation in most of the measured areas. However there were some differences at the subscale and item level. New Jersey had significantly higher implementation of planning and support, while Kansas had higher implementation of integration of mental health.

Conclusions: 

The Quality of Supported Employment Implementation Scale can be used to describe supported employment programs for individuals with severe mental illness. More research is needed.

URL: 
http://worksupport.com/Main/downloads/article5.pdf
Disabilities: 
Populations: 
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

A Supported Employment program for people with Mental Illness in Hong Kong

Authors: 
Wong, K. K., Chiu, R., Tang, B., Mak, D., Liu, J., & Chiu, S. N.
Year Published: 
2004
Publication: 
American Journal of Psychiatric Rehabilitation
Volume: 
7
Number: 
1
Pages: 
83-96
Publisher: 
Routledge, Taylor and Francis
Background: 

People with mental illness have high rates of unemployment and underemployment. Hong Kong is interested in investigating new ways to assist this population with employment. Research is needed.

Purpose: 

The purpose of this article is to report on the vocational outcomes of people with mental illness participating in a supported employment (SE) program in Hong Kong.

Setting: 

The setting was community vocational rehabilitation providers and various places of business in Hong Kong.

Sample: 

The study sample included 748 individuals with mental illness who enrolled in supported employment programs in Hong Kong.

Data Collection: 

Employment data was collected on participants, including wages and job tenure was collected.

Intervention: 

The intervention was the Individual Placement and Support model of supported employment.

Control: 

There was no control or comparison group.

Findings: 

Of the 748 participants, 458 (61.2%) obtained competitive employment. The mean job tenure was 151 days. The mean salary was HK$4,561 (US$585.00) for full-time jobs and $2,368 (US$304.00) for part-time jobs. The majority of participants (62.4%) could sustain their job placement for more than 30 days, 110 (24.0%) participants could work for more than six months, and 59 (12.9%) could maintain their jobs for more than one year.

Conclusions: 

This study concluded that IPS programs could improve vocational outcomes for people with mental illness in Hong Kong. Recommendations for future research on evaluation of the effectiveness of SE program and for further development of SE in Hong Kong were suggested.

URL: 
http://www.tandfonline.com/doi/abs/10.1080/15487760490465004
Disabilities: 
Populations: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Measurement of fidelity of implementation of evidence-based practices: Case example of the IPS fidelity scale

Authors: 
Bond, G. R., Becker, D., Baker, S., Carlson, L., Flint, L., Howell, R., Lindsay, S., Moore, M., Reeder, S., & Drake, R.
Year Published: 
2011
Publication: 
Clinical Psychology: Science and Practice
Volume: 
18
Number: 
2
Pages: 
126-141
Publisher: 
Wiley Periodicals, Inc.
Background: 

Increasing the use of evidence-based interventions is the central theme of current mental health reforms.Fidelity, as adherence to evidence-based program models (Bond, Evans, Salyers, Williams, & Kim, 2000), has also emerged as a central concept in these efforts. A fidelity scale is an assessment procedure to measure the extent to which an intervention or practice is implemented as intended. Fidelity can be measured at the system, organization, program, practitioner or client level.

Purpose: 

The purpose of the study was to examine the literature on the Individual Placement and Support Fidelity Scale to illustrate the strengths and limitations of this methodology.

Setting: 

The setting included a mixed group of Supported employment programs.

Sample: 

Review of 20 articles that examined the psychometric adequacy and practical utility of the IPS Fidelity Scale.

Data Collection: 

This article reviews the emerging literature examining the psychometric adequacy and practical utility of the IPS Fidelity Scale, addressing the following questions: (1) Does the IPS Fidelity Scale display appropriate psychometric properties (adequate reliability, content and discriminative validity, and sensitivity to change)? (2) Do programs that score higher in IPS fidelity have better employment outcomes? (3) Is the IPS Fidelity Scale a useful tool for guiding implementation in multisite projects? (4) Is the IPS Fidelity Scale useful for accrediting programs for funding decisions? (5) Is the IPS Fidelity Scale useful for monitoring purposes in formal research studies? For the first two questions, we provide quantitative evidence from published and unpublished studies. Our evidence for the remaining three questions is primarily descriptive and anecdotal.

Intervention: 

The intervention was fidelity of implementation of individual support.

Control: 

There was no control or comparison condition.

Findings: 

Findings illustrate that this scale has excellent psychometric properties. Nine of 10 studies assessing its predictive validity found positive associations with employment outcomes. Its use in quality improvement was supported by positive reports from seven multisite projects. Although not yet evaluated as an accreditation tool, three states have adopted the scale for reimbursement purposes.

Conclusions: 

Mental health reform rests on the wide-scale adoption of EBPs that are faithfully implemented. Fidelity scales are the lynchpin of both scientific advances and quality improvement. For fidelity scales to be useful, however, they must demonstrate discriminative and predictive validity. This review has documented the considerable evidence supporting the use of a fidelity scale for one EBP. Research is also needed to increase the efficiency of fidelity assessment so that it can be integrated into routine practice in the public mental health system.

URL: 
http://onlinelibrary.wiley.com/doi/10.1111/j.1468-2850.2011.01244.x/abstract
Disabilities: 
Populations: 
Outcomes: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

Predictors of vocational recovery among young people with first-episode psychosis: Findings from a randomized controlled trial

Authors: 
Baksheev, G. N., Allott, K., Jackson, H. J., McGorry, P. D., & Killackey, E.
Year Published: 
2012
Publication: 
Psychiatric Rehabilitation Journal
Volume: 
35
Number: 
6
Pages: 
421-427
Publisher: 
American Psychological Association
Background: 

A substantial body of knowledge has demonstrated the benefits of the Individual Placement and Support (IPS) model among persons diagnosed with schizophrenia. The IPS model is a form of supported employment that is based on seven key principles, including a focus on securing competitive employment positions, attending to consumers' preferences, and integration with mental health treatment teams (Becker & Drake, 2003). Limited work, however, has examined whether vocational intervention in the early phase of psychosis might also lead to improved vocational outcomes. This is important to consider more fully as the first 5 years following psychosis onset is thought to be a critical period during which the peak levels of disability associated with psychosis emerge (Birchwood & Fiorillo, 2000).

Purpose: 

The purpose of this study was to examine demographic and clinical predictors of vocational recovery among young people with first-episode psychosis who participated in a randomized controlled trial (RCT) investigating the effectiveness of the supported employment model among this population.

Setting: 

The setting was a public mental health clinic in Melbourne Australia.

Sample: 

The study sample included 41 individuals aged 17-25 with mental illness.

Data Collection: 

The study compared Individual Placement and Support and treatment as usual with treatment as usual alone. A series of logistic regression analyses were conducted to assess the predictive power of demographic and clinical factors on vocational recovery.

Intervention: 

The intervention was individual placement and support with regular treatment.

Control: 

The comparison was treatment as usual.

Findings: 

The main finding was that demographic and clinical factors did not significantly predict vocational recovery in the final multivariate analysis. Vocational recovery was solely predicted by participant group. That is, participants who were randomized to receive IPS were over 16 times more likely to secure a competitive employment position or participate in an educational activity during the follow-up period when compared with participants who were randomized to treatment as usual.

Conclusions: 

It is critical that vocational services are introduced as part of an evidence-based, multidisciplinary approach in routine clinical care at early psychosis services. Further replication of these findings is indicated with a larger sample, particularly with the addition of cognitive training interventions to further improve vocational outcomes for young people with first-episode psychosis.

URL: 
http://psycnet.apa.org/journals/prj/35/6/421/
Disabilities: 
Populations: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

Providing effective early intervention vocational rehabilitation at the community level

Authors: 
Allaire, S. J., Niu, J., Zhu, Y., & Brett, B.
Year Published: 
2011
Publication: 
Rehabilitation Counseling Bulletin
Volume: 
54
Number: 
3
Pages: 
154-163
Publisher: 
Hammill Institute on Disabilities
Background: 

The National Council on Disability noted that the number of persons with disabilities in the United States is increasing and that this is because our population is aging, and rates of disability increase with age.

Purpose: 

The purpose of this study was to evaluate the translation of positive research findings about a job retention intervention for persons with chronic illnesses to rehabilitation practice.

Setting: 

The setting was various rehabilitation counseling agencies.

Sample: 

The study sample included 57 individuals with chronic illness.

Data Collection: 

Data was collected by telephone within two weeks of the last meeting with the counselor and again at 6 months.

Intervention: 

Job retention intervention that included: vocational counseling and guidance, job accommodation, and educational and self-advocacy.

Control: 

There was no control or comparison condition.

Findings: 

Follow-up data indicated that the interventions should be more individualized. Short term outcomes evaluated in this study showed that consumer participants experienced significant improvement in awareness and confidence in ability to manage health related work problems and took actions recommended by the counselors.

Conclusions: 

The results indicate that job retention interventions can be effective when carried out in practice at the community level.

URL: 
http://rcb.sagepub.com/content/54/3/154.full.pdf+html
Populations: 
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes